Month: March 2016

Some previous epidemiologic studies have suggested that having Parkinson’s disease decreases your risk of developing cancer, and vice versa. If true, this finding could provide insight into underlying biologic mechanisms for the two diseases.

How we set out to answer the questionIn a study published in the International Journal of Epidemiology we used data from Medicare, a U.S. federal health insurance programme for those aged ≥65 years, linked to U.S. cancer registry data to examine the relationship between Parkinson’s disease and cancer. Because we used Medicare data, we were limited to people aged 65 years and older. However, as the Medicare database is very large, we were able to examine relationships in whites and non-whites, in men and women, and in different age groups (all above 65 years).

From 2010 to 2012 a P4P programme in Afghanistan provided quarterly bonus payments to health-care providers for increases in the use of maternal and child health (MCH) services, adjusted by a quality of care score. Our study, a large-scale cluster randomized trial, demonstrates that the programme did not produce the intended results. There were no observable improvements in any of the five key MCH coverage indicators measuring contraceptive prevalence, skilled birth attendances, vaccinations, and antenatal and postnatal check-ups. No changes were observed in the equity of care. While the programme appeared to increase time spent with patients, resulting in more complete histories and physical examinations, and improved patient counselling, other measures of quality, such as availability of medicines and supplies, did not substantially change. Continue reading “Lessons from the recent trial of a pay-for-performance programme in Afghanistan”→